本文選題：食管癌 + 神經(jīng)侵犯��； 參考：《新疆醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討食管癌患者存在神經(jīng)侵犯(Perineural Invasion,PNI)對預后的影響以及輔助放療對生存時間的影響。方法:回顧性分析新疆醫(yī)科大學附屬腫瘤醫(yī)院2010年1月至2015年8月期間收治的1160例行食管癌手術(shù)患者的臨床及病理資料,以術(shù)后病理有無神經(jīng)侵犯將患者分為兩組,有神經(jīng)侵犯的患者147例(12.7%),無神經(jīng)侵犯患者1013例(87.3%)。通過SPSS 17.0軟件分析兩組患者之間臨床病理因素、生存時間有無差異、以及術(shù)后輔助放療能否改善生存時間。結(jié)果:?2檢驗示兩組患者的腫瘤浸潤程度(pT)、區(qū)域淋巴結(jié)轉(zhuǎn)移數(shù)(pN)、分期(AJCC)、腫瘤部位、分化程度、病理類型、大體分型、是否有脈管內(nèi)瘤栓之間有統(tǒng)計學差異(P0.05)。單因素分析發(fā)現(xiàn)神經(jīng)侵犯與患者總生存時間(Overall Survival,OS)、無病生存時間(Disease-free Survival,DFS)均有關(guān),COX多因素分析發(fā)現(xiàn)神經(jīng)侵犯不是影響預后的獨立影響因素。通過Kaplan-Meier比較兩組生存曲線,生存曲線圖可見有神經(jīng)侵犯的患者OS、DFS明顯低于無神經(jīng)侵犯的患者(P=0.003、0.033),進一步分析有PNI患者行輔助放療較未行輔助放療患者的生存時間長。結(jié)論:PNI是一種不良預后因素,有PNI的患者總生存時間、無病生存時間均縮短,而術(shù)后輔助放療能明顯改善生存時間。
[Abstract]:Objective: to investigate the effect of perineural invading PNII on prognosis and the effect of adjuvant radiotherapy on survival time in patients with esophageal carcinoma. Methods: the clinical and pathological data of 1160 patients with esophageal carcinoma treated in Cancer Hospital of Xinjiang Medical University from January 2010 to August 2015 were retrospectively analyzed. There were 147 patients with nerve invasion and 1013 patients with no nerve invasion. SPSS 17.0 software was used to analyze the clinicopathological factors and survival time of the two groups, and whether postoperative adjuvant radiotherapy could improve the survival time. Results the tumor invasion degree, regional lymph node metastasis, AJCCI, tumor location, differentiation degree, pathological type, gross type, and whether there were intravascular tumor embolus were significantly different between the two groups (P 0.05). Univariate analysis showed that nerve invasion was associated with total survival time (total survival time) and disease-free survival time (DFSs). Cox multivariate analysis showed that nerve invasion was not an independent prognostic factor. By comparing the survival curves of the two groups by Kaplan-Meier, the survival curve showed that the survival curve of patients with nerve invasion was significantly lower than that of patients without nerve invasion. The survival time of patients with PNI undergoing adjuvant radiotherapy was longer than that of patients without adjuvant radiotherapy. Conclusion PNI is a poor prognostic factor. The total survival time and disease-free survival time of the patients with PNI are shortened, while postoperative adjuvant radiotherapy can significantly improve the survival time.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735.1

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